Provider Demographics
NPI:1205045952
Name:SPANGLER, AMY ELIZABETH (PA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:301 WATERSVILLE RD
Mailing Address - Street 2:STE 2
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5513
Mailing Address - Country:US
Mailing Address - Phone:301-345-7375
Mailing Address - Fax:301-345-7269
Practice Address - Street 1:7701 GREENBELT RD
Practice Address - Street 2:SUITE 504
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2037
Practice Address - Country:US
Practice Address - Phone:301-345-7375
Practice Address - Fax:301-345-7269
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDC0002744363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDPA57438OtherCDS NUMBER
MDC0002744OtherMD LICENSE
MDC0002744OtherMD LICENSE